Spontaneous Remission Of Marginal Zone B Cell Lymphoma In A Patient With Seropositive Rheumatoid Arthritis After Discontinuation Of Infliximab-methotrexate Treatment
Thonhofer, R., Gaugg, M., Kriessmayears, M., Neumann, H. J., & Erlacher, L. (2005). spontaneous remission of marginal zone B cell lymphoma in a patient with seropositive rheumatoid ARThritis after discontinuation of infliximab-methotrexate treatment. Annals of the rheumatic diseases, 64(7), 1098–1099. https://doi.org/10.1136/ard.2004.026252
View Original Source →Case Details
Disease Location
Sinuses
Personal Characteristics
64 -year-old female history of seropositive rheumatoid arthritis diagnosed in 1997
Clinical Characteristics
Was referred in march 2002 because of high disease activity despite methotrexate-sulfasalazine treatment. Infliximab treatment in combo with mtreatment was started and had a good response before the 16 infliximab infusion the patient reported problems with her sinuses CT scan of the sinus region suspected reactive lymphatic tissue, the lesion seemed small (3.5x2.8cm) so lymphoma and hypopharynx carcinoma was ruled out. The lesion seemed benign but biopsy was performed because of the increased risk of malignancy in ra during disease-modifying antirheumatic drug treatment (dmard) histopathological evaluation and immunohistochemistry led to the diagnosis of an extranodal marginal zone b cell lymphoma of the malt type. Dmard was discontinued. MRI of the head and neck, CT scans of the thorax and abdomen, ultrasound of the abdomen and groin, ileocolonoscopy and gastroduodenoscopy were unremarkable. Biopsy of the stomach showed helicobacter pylori infection which was treated (treatment none reported) bone marrow exam showed no evidence for lymphoma infiltration. Sjogrens syndrome signs were not present. Monthly follow-up were scheduled with no antineoplastic treatment
Remission Characteristics
MRI scan of the head and neck at 3 and 6 months showed no evidence of a tumor biopsies taken from roi showed no evidence of lymphoma infiltration complete remission
Treatment & Mechanisms
Proposed Remission Mechanisms
Stopping the dmard possibly due to the eradication of h. Pylori
Clinical Treatment
Methotrexate-sulfasalazine for 350 weeks infliximab in combo with mtreatment was treated for h. Pylori (although treatment type not elaborated except for an article reference)
Non-Clinical Treatment
None reported